US20130178704A1 - Scope Tubes, Intubation Assemblies, and Methods of Intubation - Google Patents
Scope Tubes, Intubation Assemblies, and Methods of Intubation Download PDFInfo
- Publication number
- US20130178704A1 US20130178704A1 US13/393,830 US201213393830A US2013178704A1 US 20130178704 A1 US20130178704 A1 US 20130178704A1 US 201213393830 A US201213393830 A US 201213393830A US 2013178704 A1 US2013178704 A1 US 2013178704A1
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- United States
- Prior art keywords
- lever
- fiberscope
- tube
- scope
- scope tube
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00066—Proximal part of endoscope body, e.g. handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Optics & Photonics (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Radiology & Medical Imaging (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Otolaryngology (AREA)
- Emergency Medicine (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Endoscopes (AREA)
- Physiology (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
Abstract
A scope tube may include an elongated member, a lever, a coupling member, and a handle portion. The elongated member may define a through bore tapering from a proximal end of the elongated member toward a distal end of the elongated member. The lever may be pivotally coupled to the elongated member, and the coupling member may be pivotally coupled with the lever and may extend beyond the proximal end of the elongated member. The handle portion may be fixedly coupled with the elongated tube distal of the lever. The handle portion may be proximate the lever such that a user can grasp the handle portion with one hand and operate the lever with the thumb of the same hand.
Description
- This application claims the benefit of priority of U.S. Provisional Patent Application No. 61/239,058, filed on Sep. 1, 2009, the disclosure of which is incorporated herein by reference.
- The present disclosure relates to scope tubes and, more particularly, to a scope tube slidable over a fiberscope and configured to facilitate manipulation of the fiberscope and articulation of the distal tip of the fiberscope.
- One of the most important roles of the anesthesiologist is maintaining the patient's airway open and patent during the delivery of general anesthesia. An endotracheal tube (ETT) is placed into the mouth, through the vocal cords, and into the trachea in order to maintain a patent airway and effectively oxygenate and ventilate the patient. To accomplish this, a metal laryngoscope is generally placed into the patients' mouth and used to lift the tongue and expose the vocal cords. This is referred to as direct laryngoscopy. The ETT is then passed through the vocal cords and into the trachea in a procedure known as “intubation” of the trachea. The ventilation circuit is then attached to the patient to allow oxygenation and ventilation of the patients' lungs.
- Some patients are easy to intubate while others are more difficult. Occasionally the vocal cords cannot be visualized even with direct laryngoscopy by an experienced anesthesiologist. This situation would be even more common with less experienced health care providers including physicians, paramedics, medics, etc who may need to intubate a patient outside of the operating room, in a clinic, at an accident scene, or even on the battlefield. An instrument that can see around the tongue and indirectly visualize the vocal cords would allow for intubation of the trachea in this situation.
- A fiberoptic scope can be used in this case. This is a long snake like instrument that has a light and camera on the tip and a tip that is maneuverable. Unfortunately the fiberscope requires the use of both hands to properly manipulate. One hand is used to operate a lever or other mechanism, typically located at the proximal end of the fiberscope, to maneuver the tip, while the second hand is positioned more distally and used to position the fiberscope. In a difficult airway situation, the left hand would have to release the laryngoscope in order to properly manipulate the fiberscope with two hands. Unfortunately this would allow the tongue to fall back done into the airway and obstruct visualization.
- It may be desirable to provide a mechanism by which the fiberscope could be manipulated with one hand alone while the other hand can continue to hold the laryngoscope and maintain the tongue elevated and out of the way and providing maximal possible exposure.
- According to various aspects of the disclosure, a scope tube may include an elongated member, a lever, a coupling member, and a handle portion. The elongated member may define a through bore tapering from a proximal end of the elongated member toward a distal end of the elongated member. The lever may be pivotally coupled to the elongated member, and the coupling member may be pivotally coupled with the lever and may extend beyond the proximal end of the elongated member. The handle portion may be fixedly coupled with the elongated tube distal of the lever. The handle portion may be proximate the lever such that a user can grasp the handle portion with one hand and operate the lever with the thumb of the same hand.
- In some aspects, an intubation assembly may include a scope tube, a fiberscope slidably received by and extending through the scope tube, and an endotrachial tube removably coupled with the scope tube and mounted over the fiberscope. The fiberscope may include a lever coupled to a distal tip of the fiberscope such that movement of the lever manipulates the distal tip of the fiberscope. The scope tube may include a lever coupled to the fiberscope lever such that movement of the scope tube lever causes movement of the fiberscope lever to manipulate the distal tip of the fiberscope.
- According to some aspects, a method of intubating a trachea may comprise sliding a fiberscope into and through a scope tube, removably coupling an endotrachial tube with the scope tube and over the fiberscope, maneuvering the scope tube to position the fiberscope and endotrachial tube proximate a patient's trachea; and sliding the endotrachial tube off the scope tube and into the trachea. In some aspects, the method may include moving a lever associated with the scope tube to manipulate a distal tip of the fiberscope.
-
FIG. 1 is a schematic illustration of an exemplary scope tube in accordance with various aspects of the disclosure. -
FIG. 2 is a schematic illustration of an exemplary intubation assembly in accordance with various aspects of the disclosure including the scope tube ofFIG. 1 . -
FIG. 3 is a schematic illustration of a distal end of the exemplary intubation assembly ofFIG. 2 . -
FIG. 4 is a schematic illustration of the exemplary intubation assembly ofFIG. 2 at use in a patient. -
FIG. 1 illustrates anexemplary scope tube 100 in accordance with various aspects of the disclosure. Thescope tube 100 includes atube portion 101, ahandle portion 102, and alever 103. Thetube portion 101 extends through thehandle portion 102 and includes athrough bore 105 for receiving a fiberscope. Thehandle portion 102 is fixedly coupled to thetube portion 101. Thelever 103 is pivotally coupled with thetube portion 101. Thescope tube 100 may be constructed from any material approved for medical use, as described herein. For example, thescope tube 100 may be constructed of metal, plastic, or a combination thereof. In some aspects, thetube portion 101, thehandle portion 102, and thelever 103 may be constructed of a plastic material, while the means for coupling these elements together may be constructed of a metal material. For example, thelever 103 may be pivotally coupled with thetube portion 101 via a metal pin. Other material constructions of the elements of thescope tube 100 would be understood by persons skilled in the art and are contemplated as part of the present disclosure. - Referring now to
FIG. 2 , afiberscope 200 may be inserted into thescope tube 100. For example, thethroughbore 105 of thescope tube 100 may be structured and arranged to slidably receive anyconventional fiberscope 200. In some aspects, thefiberscope 200 may be coupled to thescope tube 100 via a snug fit or friction fit relationship at a proximal region of the scope tube 100 (i.e., at the end of the scope tube into which the fiberscope is inserted). In some aspects, thescope tube 100 and/or thefiberscope 200 may include a coupling assembly for securely coupling thefiberscope 200 with thescope tube 100 once the fiberscope is inserted therein. In any event, thescope tube 100 and thefiberscope 200 shall be coupled together in a stable manner such that thescope tube 100 allows thefiberscope 200 to be easily held and maneuvered with one hand, for example, by gripping thehandle portion 102 of thescope tube 100. - An
endotrachial tube 300 may also be coupled to thescope tube 100 in a manner such that movement of thescope tube 100 will cause like movement of theendotrachial tube 300. For example, thefiberscope 200 may be inserted into thescope tube 100. Thefiberscope 200 may then extends out a distance from the distal end of thescope tube 100. Theendotrachial tube 300 may then be railroaded over the fiberscope and secured in place by the lumen of an endotrachial tube connector slipping over another short (1 cm at most) segment of tube that is at the distal end of thescope tube 100. According to some aspects, thefiberscope 200 may extend out about an inch from the distal end of theendotrachial tube 300. - The
fiberscope 200 may comprise a conventional fiberscope including alever 212 operable by a user to articulate adistal tip 216 of the fiberscope, as would be understood by persons skilled in the art. Thelever 103 of thescope tube 100 may be coupled to thelever 212 of thefiberscope 200 via acoupling member 214, for example, a thin rod or the like, which extends proximally beyond a proximal end of thescope tube 100. According to various aspects, thecoupling member 214 may have a variable length, which may be adjustable so as to accommodateconventional fiberscopes 200 of various different sizes and configurations. For example, thecoupling member 214 may comprise two or more telescoping tubes, as would be understood by persons skilled in the art. In some aspects, the telescoping tubes may be locked relative to one another once coupled with thelevers - In some aspects, the
coupling member 214 may be integrally formed with thelever 103 of thescope tube 100 as a single-piece of unitary construction. In such aspects, a proximal end of thecoupling member 214 may be coupled to thelever 212 of thefiberscope 200 by any conventional means. For example, the proximal end of thecoupling member 214 may include a housing for receiving thelever 212 in a snug fit or friction fit relationship. In some aspects, thecoupling member 214 may be coupled to thelever 212 via a snap fit assembly, a set screw assembly, or any other conventional coupling assembly. According to various aspects, thecoupling member 214 may be constructed separate from thelevers coupling member 214 may be coupled to thelever 212 of thefiberscope 200 by any conventional coupling assembly, as described above, and a distal end of thecoupling member 214 may be coupled to thelever 212 of thefiberscope 200 by any conventional coupling assembly, such as those described above in connection with the proximal end. - As would be understood by persons skilled in the art, the
coupling member 214 is pivotally coupled with thelevers levers lever 103 is pivoted relative to thescope tube 100 and thelever 212 is simultaneously pivoted relative to thefiberscope 200. For example, thecoupling member 214 may include a distal end portion pivotal relative to the elongated rod portion, as well as a proximal end portion pivotal relative to the elongated rod portion. The elongated rod portion extends in a direction substantially parallel to a longitudinal dimension of thescope tube 100. Then, the distal end portion of thecoupling member 214 is coupled to thelever 103 and the proximal end portion of the coupling member is coupled to thelever 212, such that the elongated rod portion of thecoupling member 214 is pivotal relative to thelever 103 and thelever 212. As a result, pivoting motion of eitherlever coupling member 214 substantially along an axis parallel with a longitudinal dimension of thescope tube 100. Also, movement of eitherlever - In operation, once the
lever 103 of thescope tube 100 is coupled with thelever 212 of thefiberscope 200 via thecoupling member 214, movement of thescope tube lever 103 causes a similar movement of thefiberscope lever 212, while theendotrachial tube 300 is just passively along for the ride. It should be appreciated that thefiberscope lever 212 may be coupled to adistal tip 216 of thefiberscope 200 by any known mechanism such that movement of thefiberscope lever 212 causes articulation/flexion of thedistal tip 216 of thefiberscope 200. Thus, movement of thescope tube lever 103 may cause articulation/flexion of thedistal tip 216 via thecoupling member 214 and thefiberscope lever 212. - Referring now to
FIG. 3 , thescope tube 100 may include abore 320 at its distal end. Thebore 320 may have a larger cross-section than that of thethroughbore 105. Theendotrachial tube 300 may have aproximal end portion 330 sized to snugly fit (i.e., a friction fit) into thebore 320 such that movement of thescope tube 100 causes like movement of theendotrachial tube 300. It should be appreciated that theendotrachial tube 300 may be coupled to thescope tube 100 via any conventional coupling assembly including, but not limited to, a screw fit, a key fit, a set screw, or the like. Theendotrachial tube 300 may also include aflange portion 332 that may rest against the distal end of thescope tube 100 when theproximal end portion 330 is received by thebore 320. In some aspects, theendotrachial tube 300 may include a lever or other known ejection member configured and arranged relative to thescope tube 100 so as to facilitate removal of theendotrachial tube 300 from thescope tube 100. In some aspects, thescope tube 100 may include a lever or other known ejection member configured and arranged relative to theendotrachial tube 300 so as to facilitate removal of theendotrachial tube 300 from thescope tube 100. In any event, theendotrachial tube 300 must be capable of being slid off of thescope tube 100 when in an appropriate position to be passed into the trachea. - In use, as shown in
FIG. 4 , one hand of a user can be used to hold the laryngoscope and lift the tongue up. If the vocal cords are not directly visualized via plain sight, the user's other hand can then hold thefiberscope 200 with thescope tube 100 viahandle portion 102 and thefiberscope 200 can be easily manipulated around the base of the tongue. The vocal cords can then be indirectly visualized (e.g., via a monitor operationally associated with the fiberscope) and thefiberscope tip 216 andendotrachial tube 300 can be passed through the vocal cords and into the trachea. Theendotrachial tube 300 can then be slid off thefiberscope 200 and into the trachea. The trachea is therefore successfully intubated even though the vocal cords were not visualized directly with direct laryngoscopy. - Thus, the scope tube may simplify tracheal intubation done by inexperienced health care providers. The scope tube may also simplify intubation of difficult airways done by experienced and inexperienced health care providers including anesthesiologists. The scope tube may allow limited movement of the neck in patients with known or suspected cervical spine injuries, thereby serving to avoid injury to a patient's spinal cord in these situations.
- It will be apparent to those skilled in the art that various modifications and variations can be made to the scope tubes, intubation assemblies, and methods of intubation of the present disclosure without departing from the scope of the invention. Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only.
Claims (7)
1. A scope tube, comprising:
an elongated member defining a through bore tapering from a proximal end of the elongated member toward a distal end of the elongated member;
a lever pivotally coupled to the elongated member;
a coupling member pivotally coupled with the lever and extending beyond the proximal end of the elongated member;
a handle portion fixedly coupled with the elongated tube distal of the lever, the handle portion being proximate the lever such that a user can grasp the handle portion with one hand and operate the lever with the thumb of the same hand.
2. The scope tube of claim 1 , wherein the coupling member is structured and arranged to couple the lever with a second lever associated with a fiberscope such that movement of the lever causes like movement of the second lever.
3. An intubation assembly, comprising:
a scope tube in accordance with any of the preceding claims;
a fiberscope slidably received by and extending through the scope tube; and
an endotrachial tube removably coupled with the scope tube and mounted over the fiberscope.
4. The assembly of claim 3 , wherein the fiberscope includes a second lever coupled to a distal tip of the fiberscope such that movement of the lever manipulates the distal tip of the fiberscope.
5. The assembly of claim 4 , wherein movement of the scope tube lever causes movement of the fiberscope lever to manipulate the distal tip of the fiberscope.
6. A method of intubating a trachea, comprising:
sliding a fiberscope into and through a scope tube;
removably coupling an endotrachial tube with the scope tube and over the fiberscope;
maneuvering the scope tube to position the fiberscope and endotrachial tube proximate a patient's trachea; and
sliding the endotrachial tube off the scope tube and into the trachea.
7. The method of claim 6 , further comprising moving a lever pivotally coupled with the scope tube to manipulate a lever pivotally coupled with the fiberscope in order to articulate a distal tip of the fiberscope.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/393,830 US20130178704A1 (en) | 2009-09-01 | 2012-03-01 | Scope Tubes, Intubation Assemblies, and Methods of Intubation |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US23905809P | 2009-09-01 | 2009-09-01 | |
PCT/US2010/047593 WO2011028849A2 (en) | 2009-09-01 | 2010-09-01 | Scope tubes, intubation assemblies, and methods of intubation |
US13/393,830 US20130178704A1 (en) | 2009-09-01 | 2012-03-01 | Scope Tubes, Intubation Assemblies, and Methods of Intubation |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2010/047593 Continuation WO2011028849A2 (en) | 2009-09-01 | 2010-09-01 | Scope tubes, intubation assemblies, and methods of intubation |
Publications (1)
Publication Number | Publication Date |
---|---|
US20130178704A1 true US20130178704A1 (en) | 2013-07-11 |
Family
ID=43649957
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/393,830 Abandoned US20130178704A1 (en) | 2009-09-01 | 2012-03-01 | Scope Tubes, Intubation Assemblies, and Methods of Intubation |
Country Status (2)
Country | Link |
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US (1) | US20130178704A1 (en) |
WO (1) | WO2011028849A2 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2017123941A1 (en) * | 2016-01-15 | 2017-07-20 | Farbes Medical, Llc | Imaging competent, bi-directionally articulable endotracheal tubes |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4846153A (en) * | 1988-06-10 | 1989-07-11 | George Berci | Intubating video endoscope |
US5791338A (en) * | 1994-01-26 | 1998-08-11 | William T. Merchant | Endotracheal intubation apparatus |
US5842973A (en) * | 1994-05-17 | 1998-12-01 | Bullard; James Roger | Nasal intubation apparatus |
US5976075A (en) * | 1997-12-15 | 1999-11-02 | University Of Massachusetts | Endoscope deployment apparatus |
US6432043B2 (en) * | 2000-07-19 | 2002-08-13 | Nihon Kohden Corporation | Endoscope |
US20040158159A1 (en) * | 2003-01-28 | 2004-08-12 | Olympus Corporation | Endoscope |
Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2005218786A (en) * | 2004-02-09 | 2005-08-18 | Pentax Corp | Respiratory tract observation device and adjuster |
US20080236575A1 (en) * | 2007-03-29 | 2008-10-02 | Robert Michael Chuda | Intubation device with video, stylet steering, prep and storage system |
US20090050146A1 (en) * | 2007-08-23 | 2009-02-26 | The Cleveland Clinic Foundation | Apparatus and method for intubating an airway of a patient |
TWM327719U (en) * | 2007-09-07 | 2008-03-01 | Tien-Sheng Chen | Endotracheal inner-tube probe and installation set of endotracheal inner-tube |
-
2010
- 2010-09-01 WO PCT/US2010/047593 patent/WO2011028849A2/en active Application Filing
-
2012
- 2012-03-01 US US13/393,830 patent/US20130178704A1/en not_active Abandoned
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4846153A (en) * | 1988-06-10 | 1989-07-11 | George Berci | Intubating video endoscope |
US5791338A (en) * | 1994-01-26 | 1998-08-11 | William T. Merchant | Endotracheal intubation apparatus |
US5842973A (en) * | 1994-05-17 | 1998-12-01 | Bullard; James Roger | Nasal intubation apparatus |
US5976075A (en) * | 1997-12-15 | 1999-11-02 | University Of Massachusetts | Endoscope deployment apparatus |
US6432043B2 (en) * | 2000-07-19 | 2002-08-13 | Nihon Kohden Corporation | Endoscope |
US20040158159A1 (en) * | 2003-01-28 | 2004-08-12 | Olympus Corporation | Endoscope |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2017123941A1 (en) * | 2016-01-15 | 2017-07-20 | Farbes Medical, Llc | Imaging competent, bi-directionally articulable endotracheal tubes |
US10537711B2 (en) | 2016-01-15 | 2020-01-21 | Farbes Medical, Llc | Imaging competent, bi-directionally articulable endotracheal tubes |
Also Published As
Publication number | Publication date |
---|---|
WO2011028849A2 (en) | 2011-03-10 |
WO2011028849A3 (en) | 2011-05-19 |
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Legal Events
Date | Code | Title | Description |
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STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |